This Month's Tiny Gems - September 2020

DarioHealth Corp. (NASDAQ: DRIO)

New York and Israel-based DarioHealth Corp. (NASDAQ: DRIO) leads global digital therapeutics (DTx) with its popular, smartphone-centered personalized chronic illness management software-as-a-service (SaaS). The company's strategic advantages include:

• AI-powered digital solutions that drive durable behavior change in chronic disease patients, and
• Personalized user experience at scale to make behavior change the path of least resistance.

Approximately $3 trillion in annual U.S. costs associated with chronic illnesses like diabetes, hypertension and obesity are largely preventable with behavioral therapies. Formerly limited to periodic office visits, these therapies can now scale to millions with tech-enabled, continual and remote health monitoring, as well as AI-driven digital and live coaching. This is all possible while still maintaining the personalization required for success in reducing illness and its related effects and costs.

Roughly 51,000 active, paying users manage their health with Dario's platform that combines smartphone-connected vitals measurement, remote patient monitoring (RPM), lifestyle management tools, and AI-driven and human coaching to deliver improved clinical outcomes.

Among the most downloaded medical apps, the Dario platform is rated at 4.9 stars on the Apple App Store and features 11,000 reviews, along with a Net Promoter Score (a measurement of consumers' willingness to recommend the product to others) that's the highest in its field.

Company Strategy

Clinical studies demonstrate Dario's direct improvement on users' health measures like H1AC scores (diabetes) and blood pressure (hypertension).

Patient engagement in therapies leads to health success. Dario's platform centers on continual maximization of patient engagement through personalization, including 'nudges' and live, AI-generated responses to health measures provided by Dario's smartphone-connected medical devices.

Proprietary data analysis provides valuable insights that not only improve health care providers' medical capabilities but, through artificial intelligence, encourage patients to take evidence-based and highly personalized preventative measures that reduce risk, emergency room visits and preventable hospitalization.

Dario is now deploying its successful B2C platform in B2B2C, targeting employers and health plans with competitive advantages in cost, software and hardware.

The company estimates an annual addressable U.S. market of $72 billion, only 1% of which has been penetrated with digital therapeutics.

The strategic transition to B2B2C (from exclusively B2B) is intended to accelerate revenue growth by reducing Dario's cost per acquisition per user and expanding margins.

Dario's commitment to aggressive growth is also shown by its appointment of a new president, chief medical officer and head of sales for North America, all from a highflyer behavioral health company.

Key growth drivers planned include expansion of the company's paying B2C subscriber base; lateral expansion into other chronic conditions that overlap with its core diabetes populations, such as hypertension, obesity and depression; and increased B2B2C penetration.

Financial Highlights

The company plans to leverage a massive opportunity for growth, with a global addressable market for digital therapeutics of roughly $108 billion. In the U.S. alone, that number is estimated at $72 billion, and only about 1% of that market has been penetrated.

Dario's strategic transition to an SaaS membership business model increased gross profit by 87% in Q1 2020, as compared to the prior year. Membership revenue increased from 27.1% to 46.7% in the same period. The company is seeing improved operating efficiencies as it shifts focus to the B2B2C business model, and it expects average revenue per user per month (ARPU), which was $6 and $25 in 2019 and 2020, respectively, to reach $70.

Value to Consumers and Businesses

Dario continually evaluates and optimizes the value and return its platform delivers to consumers and businesses.

Consumers seeking to understand how their everyday behavior impacts their personal health and chronic conditions benefit from actionable feedback on how to improve health and better collaborate with health care providers.

Businesses looking to increase employee satisfaction, loyalty and productivity with fewer health-related absences take advantage of Dario's services for employers.

Health care providers improve patient compliance using the platform's interactive services that allow for greater monitoring, which improve engagement with patients at the right times and with the right treatments.

Health plans can leverage DarioHealth's solutions to improve patient outcomes and lower costs.

Recent Studies

The company recently presented the results of two new studies at the American Diabetes Association's 80th Scientific Sessions, which showed sustained improvements in blood glucose levels and blood pressure among users of its digital therapeutic platform for chronic diseases. The results of these two studies demonstrate that the use of Dario's therapeutic platform promotes behavioral modification, enhanced individual engagement and improved clinical outcomes.

Remote Patient Monitoring (RPM) Agreements

The Centers for Medicare & Medicaid Services recently approved RPM codes for Medicare patients, which enables physicians to bill for between-visit patient care.

This simplifies implementation of the company's open and scalable AI-driven platform and further supports transition to the company's high-margin, recurring SaaS model targeting B2B2C revenue channels.

Emergency COVID-19 FDA Guidelines Allow Self-Test Blood Glucose Meters

In an effort to preserve personal protective equipment (PPE) and reduce contact between health care providers and patients in hospital settings due to COVID-19, the U.S. Food and Drug Administration (FDA) has recognized that home-use blood glucose meters, including Dario's smartphone-connected metering device, may be used by patients with diabetes who are hospitalized due to COVID-19 to check their own blood glucose levels and provide the readings to the health care personnel caring for them.

As a result, hospitals can now allow patients to self-test using their Dario blood glucose testing strips and smartphone-connected devices, or hospitals can issue patients Dario devices upon admission for COVID-19-related conditions.

Irregularities in blood glucose levels are suspected as a factor in the increased severity of potentially deadly COVID-19 complications. As such, a high priority is being placed on stabilization of patients' blood glucose levels.

Awards and Recognition

DarioHealth's Blood Glucose Monitoring System was voted as the 'Best Glucometer for Data Management' by Top Ten Reviews. Jeph Preece, senior editor at Top Ten Reviews, said, "The Dario app is the best data management system that I've seen. Compared to apps by popular brands, Dario's system looks and feels like it's years ahead of the curve."

'The Global Digital Health 100', an annual award sponsored by the reputable Journal of Health, recognized DarioHealth as a leader among health technology companies demonstrating the greatest potential to change the way that health care is delivered.

Net Element (NASDAQ: NETE)

On June 15, 2020, Net Element announced its entry into a binding letter of intent to merge with privately-held Mullen Technologies Inc., a Southern California-based electric vehicle company, in a stock-for-stock reverse merger in which Mullen's stockholders will receive the majority of the outstanding stock in the post-merger company. The proposed merger is currently pending the execution of a definitive agreement, shareholder vote and regulatory approval.

Net Element (NASDAQ: NETE) is a global financial technology and value-added solutions group that supports electronic payments acceptance in an omni-channel environment spanning across point-of-sale, e-commerce and mobile devices. The company operates a payments-as-a-service transactional model and value-added services platform for small to medium enterprises in the U.S. and selected emerging markets.

Net Element believes the future of global commerce is being revolutionized as consumers quickly migrate toward omni-channel shopping utilizing mobile devices, desktop, and online services. The company's all-in-one payment solutions support and unify a whole range of applications through a single, robust platform, allowing global onboarding and support for multiple payment methods.

Net Element has also launched a blockchain-focused business unit that will develop and deploy blockchain technology-based solutions. Net Element expects the new division to create a decentralized crypto-based ecosystem that will act as a framework for an unlimited number of value-added services, connecting merchants and consumers in a seamless, economically efficient transaction. This new business unit intends to also identify and invest in unique projects that decentralize and disrupt the payment processing industry by combining blockchain technology and real-world applications with talented development teams, strong fundamentals and addressable markets large in size.

"We believe that we're at the dawn of a new evolution where additional digital payment methods are being introduced," Net Element chairman and CEO Oleg Firer, says. "Introduction of our division focused on blockchain as part of the NASDAQ-listed entity will add transparency and compliance assurance to our investors as well as provide access to deploy value-added services to over 20 million electronic commerce clients that are currently part of Net Element's growing network."

Net Element clients are treated to customized solutions that provide the flexibility needed to keep up with customers. Among the services offered are mobile payment apps that accept payments anywhere, anytime; cloud-based solutions built to increase productivity and enhance revenue for clients and partners; marketing solutions that turn lookers into buyers; and business analytics that make it easy for clients to monitor business metrics, engage with customers and compare the competition. Its multi-channel platform combines e-commerce, offline, point-of-sale, comprehensive back office tools, mobile point-of-sale, credit scoring and customer interaction in one powerful platform-as-a-service technology.

Net Element owns and operates a global mobile payments and transactional processing provider, TOT Group, Inc., with the following subsidiaries:

• Unified Payments – An award-winning, customized mobile billing and payments solution, recognized by Inc. Magazine as the No. 1 Fastest Growing Company in America in 2012.
• Aptito – A next-generation, all-in-one, cloud-based restaurant management and point-of-sale payments platform using wireless technology.
• Payonline – A fully integrated, processor agnostic electronic commerce platform.

Net Element is ranked on Deloitte's Technology Fast 500™ list of North America's 500 fastest growing technology, media, telecommunications, life sciences and energy tech companies in both 2017 and 2018, during which the company grew 190 percent and 183 percent, respectively. The company credits its progression to organic growth in its North America Transactions Segment, specifically the success of its Unified Payments brand, which focuses on value-added payment acceptance solutions for small to medium enterprises in the United States.

Net Element was also listed among South Florida Business Journal's 2016 fastest growing technology companies.

Leveraging its suite of application performing interfaces (APIs) and connectors, Net Element powers commerce for businesses of all sizes through multi-channel platforms, all-in-one digital solutions, and end-to-end encryption of cardholder data utilizing tamper resistant hardware that ensures integrity and simplifies security.

Leading this innovation is chairman and CEO Oleg Firer, who is responsible for the overall vision, strategy and execution of the company's mission of powering global commerce. He is joined by CFO Jeffrey Ginsburg, CPA, and Steven Wolberg, the company's chief legal officer and secretary. Each corporate officer brings a unique blend of leadership, vision, experience and creative energy to the company.

From mobile payments and value-added transactional innovations like Aptito to e-commerce and retail payment transaction processing brands like Payonline and Unified Payments, Net Element is transforming the online and mobile experience.

Trxade Group Inc. (NASDAQ: MEDS)

Trxade Group Inc. (NASDAQ: MEDS) is an integrated pharmaceutical services company that offers a unique combination of a web-based purchasing platform (www.trxade.com) for transactions between independent pharmacists and drug distributors (B2B); a network of pharmacies with E-Hub software; a mail order pharmacy; and warehouse and drug delivery services. This synergistic combination of product offerings and superior data analytics is poised to benefit all stakeholders and consumers within the pharmaceutical industry.

Trxade will leverage and scale its fully integrated model to execute the following growth strategies:

• Increase share of pharmacist drug purchasing
• Additional SKUs and expand product breath
• Partner with Specialty and International Mfg.
• Expand mail order licenses to all 50 states
• Scale Delivmeds for consumer delivery nationwide
• Integration with telemedicine
• M&A Opportunities within drug value chain

Founded in 2010 and headquartered in Tampa, Florida, Trxade's overarching corporate strategy is to penetrate the existing retail independent pharmacy marketplace and diversify the company's pharmaceutical mix with additional specialty and acute care products. Trxade is advancing on this mission by focusing on three key niches in the health care market.

Business-to-Business (B2B)

The $330 billion U.S. pharmaceutical industry is comprised of more than 65,000 pharmacy facilities and 1,500 state-licensed suppliers. Roughly 24,000 of these facilities are independent pharmacies, which collectively spend approximately $93 billion a year on branded and generic drugs.

Trxade targets these independent pharmacies, leveraging a robust, "E-Bay/Kayak-like" technology platform with optimum buyer/seller pricing algorithms, product availability, and predictive data analytics features.

Trxade currently serves and transacts with more than one-third (10,250) of these independent pharmacies and facilitates over $10 million of drug purchases a month!

Consumer

Trxade also targets the "consumer side" of the pharmaceutical industry, aiming to lower prescription drug costs by attacking the inefficient value chain; offering drug price transparency and efficient buying; and, delivering drugs DIRECT to independent pharmacists and consumers.

The company operates a full-service mail order pharmacy for U.S. consumers, as well as a mobile app called "Delivmeds" (http://www.delivmeds.com) which enables SAME DAY home delivery of dispensed prescriptions.

Retail

Trxade's Managed Services Organization ("TrxadeMSO") enables its member independent retail pharmacies to get patients, process orders, and deliver or ship prescriptions to patients. TrxadeMSO provides access to encompassing network of pharmacies through the E-Hub software, allowing for timely and comprehensive medication fulfillment.

These offerings ensure the best-suited pharmacy receives the patient's information, thereby ensuring appropriate medication coverage based on the patient's location, payor coverage, and medication access/inventory. This will save the clinicians and their staff time as they benefit from efficiency and enhanced workflow management in script processing and fulfillment.

Health Care Market 

The U.S. health care market currently hovers near $4 trillion and is expected to grow as the general population ages. This growth will have greater impact on consumers as out-of-pocket expenses also rise. Additionally, drug costs are paced to increase faster than the overall health care and well above inflation.

Drug pricing is variable, and reimbursement is squeezing profits. This provides significant opportunity for the Trxade model of price visibility and profit optimization.

Trxade's fair online market platform targets the nation's retail community and independent pharmacies, of which there are approximately 24,000 nationwide. TRxADE has found that independent pharmacies, in order to be cost-effective, often operate with minimal staff and conduct up-to-the minute price checks. The TRxADE S2P platform gives these pharmacists the ability to easily compare the price of drugs offered by various suppliers and select the most favorable deals, saving money by taking advantage of best purchase pricing.

TRxADE's programs include:

• TRxADE Exchange, which opens and widens the distribution channel to the retail, community pharmacy. A purchasing pharmacy can view products from manufacturers, buying groups, and wholesalers on a real-time and continuous basis. This approach significantly enhances the competitive spirit of the exchange where the lowest price exists for each product at any given point in time. TRxADE has become a competitive tool for all progressive entities and is recognized for its easy searching of hard-to-find generic pharmaceuticals at substantially reduced prices.  
• RX Guru™ is an industry-leading price prediction model that integrates product shortage insight into pharmacy acquisition benchmarks ("PAC") to ascertain trends and pricing variances that result in significant purchasing opportunities. RX Guru affords members the opportunity to continuously benefit from real price purchasing opportunities that are concealed from the rest of the industry. 
• Product Shortage Database – TRxADE maintains the most comprehensive retail, specialty and acute care pharmaceutical product shortage database in the country. Other industry competitors mainly restrict their efforts to specialty and acute care product shortages and narrowly research oral generic products. TRxADE's advanced prediction tools help members source those hard-to-find products at affordable costs in a timely and easy-to-search process. 

Management Team 

Trxade's management team is rich in expertise within the pharmaceutical supply chain and is supported by a base of advisors and contractors who are experts in related fields of the pharmaceutical sector.

Suren Ajjarapu – Chairman of the Board, Chief Executive Officer and Secretary

Suren Ajjarapu has served as Trxade's chairman of the board, CEO and secretary since 2014, and as the chairman of the board, chief executive officer and secretary of Trxade Nevada since its inception. Ajjarapu also serves as a chairman of the board for Feeder Creek Group Inc., since March 2018. Ajjarapu formerly was a founder, CEO and chairman of Sansur Renewable Energy Inc., a company involved in developing wind power sites in the Midwest, United States; a founder, president and director of Aemetis Inc., a biofuels company (AMTX.OB); a founder, chairman and CEO of International Biofuels, a subsidiary of Aemetis Inc.; and a co-founder, COO, and director at Global Information Technology Inc., an IT outsourcing and systems design company. Ajjarapu holds an M.S. in environmental engineering from South Dakota State University, Brookings, South Dakota, and an MBA from the University of South Florida, specializing in international finance and management. Ajjarapu is also a graduate of the Venture Capital and Private Equity program at Harvard University.

Prashant Patel – Director, President and Chief Operating Officer

Prashant Patel has served as Trxade's full-time president and COO, and as a director since the company's acquisition of Trxade Nevada in 2014, and as the COO and president and as a director of Trxade Nevada since its inception. He has been a president and member of the board of Trxade since August 2010. Patel is a registered pharmacist and pharmaceutical consultant with over 10 years of experience in retail pharmacy and pharmaceutical logistics. He is the founder of several pharmacies in the Tampa Bay area, in Florida. Since 2008, Patel has been managing member of the APAA LLC pharmacy. Since 2007, Patel has been a vice president of Holiday Pharmacy Inc. Patel graduated from Nottingham University School of Pharmacy and practiced in the United Kingdom before obtaining his masters in Transport, Trade and Finance from Cass Business School, City University, UK.